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Senates to be watered down

Ministers are poised to backtrack over the controversial introduction of clinical senates, promising to limit their role in GP commissioning, Practical Commissioning has learned.

The senates - introduced after the Government´s first listening exercise to quell fears over GP commissioners´ accountability - will have no role in approval of clinical commissioning groups and no power over commissioning decisions.

In its response to the Future Forum´s report on the health reforms in June, the Department of Health said the senates would be introduced in each area of the country to ‘provide multi-professional advice on local commissioning plans'. But the move angered fledgling GP commissioning groups who feared they could interfere with their independence.


Dr Mike Dixon, chair of the NHS Alliance told Practical Commissioning: ‘We´ve been fighting quite fiercely on this. I´ve got promises all round that they will have no role in the approval of clinical commissioning groups and no veto on commissioning decisions.'

Dr Dixon added: ‘Since the listening exercise, there has been a general feeling among GP commissioners that the balance of power has shifted back towards the centre. CCGs have been caught in the political crossfire and some of the outcome has been the neutralising of commissioners. The introduction of senates has been totally out of order. The 2010 White Paper talked about "liberating" - well that´s not what CCGs have been feeling since the first listening exercise.'

He added that a new battle was brewing over commissioning support because of ‘patchy' engagement from PCT clusters. ‘Some CCGs are getting the leftover staff the PCT doesn´t want and others are being told they´ll "get what they get" in terms of support. There´s a big variation in atmosphere and it all adds to the feeling that power is being passed back to the centre."

GPs contacted by Practical Commissioning about clinical senates in July felt they would hamper their efforts. Dr Gurkirit Kalkat, chair of Barking and Dagenham CCG said: ‘It could hinder progress. It´s basically a PEC and personally I was hoping we might be able to bring about change quicker than we could under a PEC.'

Dr Dixon added that the second stage of the Government´s listening exercise announced in July had an element of ‘window dressing' about it and said it was largely irrelevant to CCGs who wanted to ‘brook no further delay and get on with the job.'

The exercise will focus on education and training, information and public health. A new workstream focusing on integration - as opposed to competition - has now been added.

The NHS Future Forum will continue to be chaired by Professor Steve Field, the former RCGP chair. Its membership has been expanded to over 50.


Prime Minister David Cameron launched the initiative last week as it emerged that the health bill will face stiff opposition in the House of Lords - despite heavy amendments aimed at quelling further opposition to its progress.


With Lib Dem and cross-bench peers from Dame Shirley Williams to Lord Owen queuing up to attack the bill, its progress looks rocky.


Our sister paper Pulse reported last week that Lord Rea a Labour peer and former GP is set to launch a series of amendments to derail it.


Lord Rea told Pulse he will draft amendments in support of the BMA's call for the bill to be withdrawn and predicted the Government would ‘struggle' to secure the bill's passage. The bill returns to the House of Commons for its report stage and third reading on 6 September, and will then move to House of Lords, with a second reading expected there in October.